Title Page
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Division:
- Electrical Servicing
- Fire Servicing
- Networks-NP
- Networks-TGA
- Networks-PN
- Networks-HAM
- Civil Works-NP
- Civil Works-HAM
- Streetlighting
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Auditor:
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Audit Number: (HSEQ only)
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Date:
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Customer/Client/Contract:
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Location
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Job No:
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Job Description:
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Critical Risk Activities to consider
- Driving
- Working at height
- Working Near Live Electricity
- Working with or near Mobile Plant
- Hazardous Substances
- Working around others
- Manual Handing
- Cranes & Lifting
- Working with or near Traffic
- Working around Underground Services
- Working Alone
- Confined Space Work
Personnel on site:
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Name:
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Role:
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Signed onto JSEA:
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Competency for Task:
Audit Element
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Work is approved/authorized
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Scope of work understood and maintained
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PCBU's consulted at shared site
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Hazard controls implemented and maintained
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Emergency preparation documented
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Site control effective-cones, signs, sign in register
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Public protection controls effective
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Risk assessment completed (JSEA)
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FA Kit/Fire Extinguisher/Spill Kit available
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PPE used correctly
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Site tidiness
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Ladders positioned safely
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Permits if applicable
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Traffic Management Plan if applicable
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Vehicles and plant inspected
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Plant used safely- EWP
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Vehicle information pack available
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Electrical leads and tools/appliances test tagged
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Meters/Test equipment tested and labeled
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Tools and equipment used safely
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Hazardous Substances management-SDS
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Subcontractor management completed
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Quality of work inspected
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Test records completed
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As built/As installed correct
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Testing compliant to AS/NZS3000, AS/NZ3760
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Covid-19 site management ( as applicable)
Summary of audit discussion with personnel on site:
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Summary of audit discussion:
Sign Off
- Sign Off
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Auditee Name & Signature
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Auditor signature
